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      Learning to Bury the Dead during COVID-19 – Barbarism or Indigeneity?

      letter
      , PHL, MA, STHB
      Prehospital and Disaster Medicine
      Cambridge University Press
      COVID-19 deaths, cremation, pandemic, process of grieving

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          Abstract

          To the Editor, The journal has lately published about “COVID-19 and Unfinished Mourning” and it has rightly expressed the continuing grief and psychological impact that families of those who have lost loved ones experience during the pandemic. 1 Learning to bury the dead during the pandemic “disaster” 2 is then a matter of crucial preparatory concern that must not be neglected. As of the 5th of September 2020, there are already almost one million deaths and the mortality rate is still fluctuating at high levels. 3 In the Philippines, the practice of “cremations, online funerals, and wakes with a limited number of attendees to maintain physical distancing will continue to be the ‘new normal’ in the mortuary industry.” 4 Crematoriums, such as those in Arlington Memorial Chapels and Crematory (Quezon City, Philippines), have limited their cremations to 10 a day, even with those who had not died of COVID-19. Considerations include: (1) the cremation of those who died due to COVID-19 within 12 hours; (2) a video viewing of the crematory process; (3) the allowance of at least one member, upon insistence, to be physically present with protective equipment; and (4) certification needed for non-COVID deaths. The distortion of the natural process of grieving in this regard creates psychological problems. Within pandemic burial protocols, the “rapid cremations” are said to be “impersonal” but also “traumatizing;” “I think the fact that… my family wasn’t able to say goodbye could probably be the second most tragic thing that happened after my dad’s death” says one family member. 5 On such point, Agamben notes that “the threshold that separates humanity from barbarism has been crossed” and further interjects: “how could we have accepted, in the name of a risk that […] people who are dear to us, and human beings more generally, should have to die alone […] that their corpses should be burned without a funeral?” 6 The image that captures Agamben’s thought in the possible normalization of COVID-19 burial protocols is that the dead “– our dead – have no right to a funeral.” 7 As a preparatory psycho-social support mechanism, indigenous practices can pave way for adaptation in dealing with the dead. There may be many indigenous customs of burying the dead in the Philippines, but interviews with the Mamanwa of Basey on the island of Samar, Philippines specifically show that they simply leave the dead to where they died during disastrous resistances. 8 The dead, they believe, are dead and the embrace of life’s natural process is emphasized. The case of either barbarism or indigeneity in this regard are lenses that make sense in disaster health. But there might be more lessons that can be learned on the ways in which indigenous communities handle deaths. This is to conclude that learning from indigenous ways of coping in dealing with the COVID deaths may mitigate the effects of psychological damage and possibly render as a compensation their preemption and continuous reorientation to the natural course of things.

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          COVID-19 and Unfinished Mourning

          To the Editor, Coronavirus disease (COVID-19) is an infectious respiratory disease that first emerged in Wuhan, China in December 2019. 1 It spread rapidly to many countries in the world, and the World Health Organization (WHO; Geneva, Switzerland) declared this virus a global pandemic on March 11, 2020. 2 As of April 10, 2020, according to Johns Hopkins University Coronavirus Resource Center (Baltimore, Maryland USA), there were more than 1,603,330 confirmed cases in 185 countries, and at least 95,758 lost their lives. 3 The number of confirmed cases and deaths is expected to increase in the coming days. 2 The natural response of human beings to the death of their loved ones is expressed in grief and mourning. 4 It is known that the traditional funeral and burial are parts of the grieving process that give mourners an opportunity to express feelings and emotions about their loved ones. 5 Improper response to grief puts them at risk of mental health disorders (ie, depression or anxiety), persistent grief, a prolonged mourning process, as well as reduced quality of life. 6 A study by Eleston J (2017) showed that with the outbreak of Ebola, social psychological problems were associated with increased family grief and reduced quality of life. 7 Since COVID-19 is highly contagious, patients are dying without their families or friends by their side. 8 As the COVID-19 pandemic evolved, large gatherings were prohibited and physical distancing was applied to contain the spread of the virus. 5 This pandemic led to psychological crises. Lockdowns and restrictions altered the way people grieve, no manner what their culture and religion are. This limited people’s ability to mourn and restricted funeral services and rituals. The safe management of dead bodies in the context of COVID-19, that was set by governments for public health and safety reasons, led the public funeral and burial processes to change. People were deprived of the most important rituals that normally occur following a death. In the absence of these ceremonies, families and friends can’t stay in contact with the bereaved and express their support, caring, and love. Instead, they are left alone to deal with their overload of grief and emotional exhaustion. Indeed, a sense of profound sadness will remain in entire communities. 9 It is necessary to deal with this issue with great urgency. In the current situation, mental health providers can help people to cope with grief and to strengthen them by identifying ways to move forward. This can be achieved by providing rehabilitation programs and specialized counseling to the family and relatives of the deceased, and ensuring continuous follow-up. The social and mental support can help individuals to better understand reality, organize their lives, cope with stress, and reduce the suffering caused by the loss of loved ones, to compensate the natural mourning process.
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            COVID19 - The need for Public Health in a time of emergency

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              Theorizing Mamanuan Diaspora: from vanishing mediator to performative indigeneity

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                Author and article information

                Journal
                Prehosp Disaster Med
                Prehosp Disaster Med
                PDM
                Prehospital and Disaster Medicine
                Cambridge University Press (New York, USA )
                1049-023X
                1945-1938
                25 September 2020
                : 1-2
                Affiliations
                Curator and Research Coordinator for the Social Sciences and Values Education, Leyte Normal University , Tacloban City, Philippines
                Author notes
                Correspondence: Jan Gresil Kahambing, PHL, MA, STHB, Leyte Normal University , Paterno Street, Tacloban City, Philippines, 6500, E-mail: jan_kahambing@ 123456lnu.edu.ph
                Author information
                https://orcid.org/0000-0002-4258-0563
                Article
                S1049023X20001235
                10.1017/S1049023X20001235
                7542310
                32972482
                83041725-5249-48ec-a3b6-d75355e26f2a
                © World Association for Disaster and Emergency Medicine 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 September 2020
                : 19 September 2020
                Page count
                References: 8, Pages: 2
                Categories
                Letter to the Editor

                covid-19 deaths,cremation,pandemic,process of grieving
                covid-19 deaths, cremation, pandemic, process of grieving

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